Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the aggressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale(28item, 4 likert scale), Shere's Self-Efficacy Scale)17item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist)34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation co-efficient. Results of this study are summarized as follows : 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as : lack of clarity(2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured from 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be influenced significantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high(Mn 2.78). The degree of coping related to be influenced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001). From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.
Child* ; Health Personnel ; Humans ; Nursing ; Parents ; Parturition ; Prognosis ; Uncertainty* ; Child Health

To evaluate the ultrastructural changes and the mechanism causing liver injury by lead, light and electron microscopic(LM and EM) examination using Timm sulphide silver method(TSM) was done. Sprague-Dawley rats were divided into a control and 3 experimental groups. The experimental groups were orally administered 0.5% lead acetate(LA). Group 1 received a one time dose of 10 ml of LA by gastric intubation. Groups 2 and 3 continuously received LA instead of drinking water. The control group was composed of 3 rats in each group which did not receive any treatment. Rats of group 1, 2 and 3 and control were sacrificed at 1/2, 1, 1 1/2 hours, 2 days, and at 1, 2, 4, 6 and 8 weeks later, except group 3. Before sacrifice, they were perfused with 0.1% sodium sulphide and 2.5% glutaraldehyde through the abdominal aorta for TSM. The liver was taken for LM and EM examinations. Blood lead concentration began to increase from the 2nd day up to 3.29 microgram/ml at 2nd week, and the urinary delta-ALA level showed a steady increase from the 2nd day. LM and EM examination of liver revealed that absorbed lead granules in group 1 were transported into sinusoidal spaces, Kupffer cells, and the hepatocytes within 1 hour and then disappeared 1/2 hour thereafter. In group 2 deposited lead was found in the hepatocytic cytosol bound to mitochondria. That in turn inhibited mitochondrial respiration with resultant mitochondrial swelling at the 1st week and thereafter at 6th week myelin figure formation and condensation of mitochondria, and peroxisomes were increased at 8th week. Based on these results it can be concluded that a transient intake of subletal dose of LA is biotransformed completely by periportal hepatocytes within 1 1/2 hours, but excessively accumulated lead can induce liver cell injury due to lipid peroxidation of membrane by direct toxic effect of lead and by products of lipid peroxidation. We postulate that lead acetate triggers presumably primarily mitochondrial membrane injury and then other organellar changes may play a role in disturbance of a network of interacting of key events capable of causing cell death.
Rats ; Animals

PURPOSE: This study aimed to examine the effects of subjective memory complaints, depression and cognitive function on performance of activities of daily living (ADL) in individuals with mild cognitive impairment (MCI). METHODS: A total sample consisted of 250 MCI patients diagnosed within one year. All participants were assessed with a battery of standardized neuropsychological tests, self-report measures of subjective memory complaints and depression, and performance of basic and instrumental ADL. Correlational and multiple linear regression analyses were conducted to identify the factors associated with performance of basic and instrumental ADL, respectively. RESULTS: Executive function and depression explained 9.4% of the variance in basic ADL. Reduced executive function and greater depressed mood were associated with worse performance on basic ADL. Executive function, subjective memory complaints, and time since onset of cognitive symptoms accounted for 22.2% of the variance in instrumental ADL in individuals with MCI. Lower executive function (t=−2.02, p=.044), greater memory complaints (t=5.36, p<.001), and longer periods of experiencing cognitive symptoms (t=2.24, p=.026) were associated with worse instrumental ADL performance. CONCLUSION: These results may help healthcare professionals develop interventions to improve cognitive outcomes with better understanding of the relationship among cognition, mood, and behavioral performance in individuals with MCI.
Activities of Daily Living ; Cognition ; Delivery of Health Care ; Depression ; Executive Function ; Humans ; Linear Models ; Memory Disorders ; Memory ; Mild Cognitive Impairment ; Neurobehavioral Manifestations ; Neuropsychological Tests

PURPOSE: The purpose of the study was to identify and explain the essences and structures of maternal conflicts in Vietnamese married immigrant women in Korea. METHODS: A phenomenological methodology was used for the study. Eleven Vietnamese married immigrant women participated in the study. Verbatim transcripts were analyzed using Colaizzi's method. RESULTS: Four categories, 10 clusters and 26 themes emerged from the data for the experience in maternal conflicts of Vietnamese married immigrant women. The four categories were 'An unprepared young motherhood in another culture', 'Feeling left out of the mother's place along the bands of Nap tai tradition', 'My image is like not-being able to stand alone/be independent' and 'Finding hope in motherhood despite of conflicts and stigmas'. CONCLUSION: Vietnamese married immigrant women experienced not only the negative aspects but also sublimation of maternal conflicts. Based on the results, health professionals need to develop effective nursing interventions toward a positive maternal identity and approach with interculturalism for the Vietnamese married immigrant women in Korea.
Adaptation, Psychological ; Adult ; Communication Barriers ; Emigrants and Immigrants/*psychology ; Family/psychology ; Female ; Humans ; Interviews as Topic ; Marriage ; Maternal Behavior/*psychology ; Pregnancy ; Quality of Life ; Questionnaires ; Republic of Korea ; Vietnam

BACKGROUND: One of the problem in emergency room(ER) of university hospital is over-crowdedness that causes exhaustion of medical resources (personnel, device, space) and disturbes optimal treatment. METHODS: This is an evaluative research for the purpose of promoting efficient operation system in ER of university hospital. RESULTS: 1) In 387 visitors, mean age was 47.5 years, and male to female ratio 1.21:1. As the specialty in charge, 28.9%f them were internal medicine, 26.6%mergency medicine, 9.9%eurology, and 8.5%eurosurgery. 24%f visitors have come by ambulances. The patients stayed for average 16.1 hours. The admission rate of ER visitors was 33.4 %60.3 %returned home after some management. 2) The visitors had various causes without correlation between the severity of conditions and the choice of high level hospital ER. They perceived their situations emergent in 78.4% but after triage only 25.6%were classified emergent. 48.6%of the visitors were the patients of out-patient department of this hospital due to chronic diseases. 3) The patients were assessed within 9.5 minutes after arrival at ER by nurse and within 34 minutes by doctor. If they were in need of consultation to second/third department, they waited for 141.5/460 minutes respectively to see the doctor. They waited for 59.9/52.7 minutes to get routine laboratory sampling/radiologic examination respectively. 4) Every 2.3 new patients visited this ER per hour. Average 63.2 patients were taken over to next shirt of nurse duty, and 60%of them had chronic degenerative diseases. CONCLUSION: The causes of overcrowding in ER of the university hospital were (1) huge number of patients at out-patient department of the hospital, (2) shortage of beds compared to the number of patients waiting admission, (3) too many kinds of procedures performed in ER, (4) cooperation failure among doctors of different specialty, and (5) no definite criteria of admission/discharge into/from ER. To solve these problems, conversion of ER management policy from complete examination and treatment to more simple and rapid one is necessary.
Ambulances ; Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals ; Humans ; Internal Medicine ; Male ; Outpatients ; Triage

No abstract available.
Krukenberg Tumor*

No abstract available.
Krukenberg Tumor*

When bronchogenic carcinoma is coexisting with pulmonary tuberculosis, it is difficult to differentiate bronchogenic carcinoma from pulmonary tuberculosis radiologically. Thus, the object of this study is to define differential diagnosis of bronchogenic carcinoma by computed tomography. We analized CT scans of 27 patients with radiologic findings of pulmonary tuberculosis and mass of which twelve cases were pulmonary tuberculosis and fifteen cases were primary lung cancer. The location of parenchymal infiltration and the mass was the same in 60%(9/15) of the primary lung cancer in cases and 83%(10/12) of the pulmonary tuberculosis cases. The common location of the mass was the both upper lobes in 92%(11/12) of the pulmonary tuberculosis cases and 53%(8/15) of the primary lung cancer cases. The common locations of the mediastinal lymphadenopathy were 4R, 2R of the pulmonary tuberculosis cases and 4R, 10R of the primary lung cancer cases. In the feature of post enhanced lymph nodes, homogenous increased density was more frequent in primary lung cancer. Measurements of the maximum thickness part of the cavity wall was not a reliable indication of malignancy.
Carcinoma, Bronchogenic ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Lymphatic Diseases ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary*

The purposes of this study were to measure the degree of perceived uncertainty, social support & powerlessness, to examine the relationship between the perceived uncertainty, social support & powerlessness and then to find the predictors of powerlessness in mother's of handicapped children. The subjects of this study consist of 102 mothers of handicapped children, registered at rehabilitation & handicapped children school. Data was collected from September 1998 to March 1999. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Miller's Powerlessness measurement Scale(28 item, 4 likert scale) & Cohen's Interpersonal Support Evaluation List(40 items, 4 liken scale). Data was analyzed by t-test, ANOVA, Duncan comparison, Pearson Correlation coefficient & Stepwise multiple regression Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high(Mn 2.50). The degree of perceived uncertainty by the four components were followed as lack of clarity(2.69), unpredictability(2.56), ambiguity(2.56) & lack of information(2.46). The degree of perceived uncertainty of the mothers of handicapped children revealed to be influenced significantly by age of children, admission experience, disability types of children. 2. The degree of mothers' powerlessness was measured to be slightly high(Mn 2.14). The degree of perceived powerlessness of the mothers with handcapped children revealed to be influenced significantly by age of children, duration of illness admission experience, & marital status of the mothers. 3. Mothers perceived their social support to be slightly high(Mn 2.71). The degree of perceived social support revealed to be influenced significantly by sex of children, married state of mothers. 4. Mothers' uncertainty was related positively to the mothers' powerlessness(r=.33, p=.0008). And also mothers' powerlessness was related inversely to social support(r=-.50, p=.0001). But, mothers' uncertainty was not related to social support significantly. 5. To analyze the variables which affect powerlessness, stepwise regression was implemented. As a result, about 61% of the powerlessness were explained by social support, marital status of the mothers and perceived uncertainty. Based upon these results, it is recommended that the nurses, who are caring handicapped children and their families, provide various support programs for them to overcome their difficulties. Also programs which decrease the uncertainty & powerlessness used social support multidimensionally & individually are recommended to be developed.
Child ; Disabled Children* ; Disabled Persons* ; Humans ; Marital Status ; Mothers* ; Rehabilitation ; Uncertainty* ; Child Health

Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*